临床研究(Clinical Research)

肠系膜上动脉综合征致胃食管反流性咳喘:附6 例报告

Published at: 2015年第24卷第12期

朱广昌 1 , 汪忠镐 1 , 卞策 1 , 吴继敏 2 , 侯国锋 1 , 胡志伟 2 , 马超 1
1 第二炮兵总医院心脏大血管外科,北京 100088
2 第二炮兵总医院胃食管反流中心,北京 100088
通讯作者 广昌 朱 Email: zhuguangchang878@sohu.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.12.018
基金:

摘要

目的:探讨肠系膜上动脉综合征(SMAS)所致胃食管反流(GER)性咳喘的诊治方法。 方法:回顾性分析6 例SMAS 致GER 性咳喘患者的临床资料。 结果:患者的临床表现主要为上腹间断性胀痛、反酸、烧心、咳嗽、哮喘等,上消化道造影示十二指 肠水平段受压。2 例行保守治疗,4 例行手术治疗。随访1.5~84 个月,3 例术后症状改善明显,1 例术 后并发胃瘫,予胃动力药物治疗后缓解;2 例保守治疗,症状得到有效控制,但需长期服质子泵抑制 剂及胃动力药物。 结论:SMAS 致GER 性咳喘的诊治需兼顾SMAS 和GER,手术与保守治疗相结合可获满意疗效。


Gastroesophageal reflux-associated asthma caused by superior mesenteric artery syndrome: a report of 6 cases

Abstract

Objective: To investigate the diagnosis and management of gastroesophageal reflux (GER)-associated asthma due to superior mesenteric artery syndrome (SMAS). Methods: The clinical data of 6 cases of GER-associated asthma caused by SMAS were retrospectively analyzed. Results: Of the patients, the main clinical manifestations included intermittent upper abdominal bloating pain, acid regurgitation, heartburn, cough and asthma, and upper gastrointestinal contrast showed compression of the horizontal part of the duodenum; 2 cases received conservative treatment, and 4 cases had surgical treatment. Follow-up ranged from 1.5 to 84 months; of the postoperative patients, the symptoms in 3 cases were improved, and one case developed gastroplegia which was relieved by gastric motility-promoting drugs. The symptoms in the two patients receiving conservative treatment were effectively controlled, but long-term treatment with proton pump inhibitors and gastric motility-promoting drugs were required. Conclusion: Both SMAS and GER should be taken into consideration in diagnosis and treatment of GERassociated asthma caused by SMA, and satisfactory results may be achieved by surgical or conservative treatment.


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引用

引用本文: 广昌 朱, 忠镐 汪, 策 卞, 继敏 吴, 国锋 侯, 志伟 胡, 超 马. 肠系膜上动脉综合征致胃食管反流性咳喘:附6 例报告[J]. 中国普通外科杂志, 2015, 24(12): 1732-1736.
Cite this article as: ZHU Guangchang, WANG Zhonggao, BIAN Ce, WU Jimin, HOU Guofeng, HU Zhiwei, MA Chao . Gastroesophageal reflux-associated asthma caused by superior mesenteric artery syndrome: a report of 6 cases[J]. Chin J Gen Surg, 2015, 24(12): 1732-1736.